Minimally Invasive Transthoracic Intramyocardial Cellular Transplantation Under Echocardiographic Guidance for Myocardial Impairment
10.1097/CD9.0000000000000142
- VernacularTitle:Minimally Invasive Transthoracic Intramyocardial Cellular Transplantation Under Echocardiographic Guidance for Myocardial Impairment
- Author:
Sulei LI
1
;
Bo TAO
;
Junsong LIU
;
Dongyue LIU
;
Yujia WANG
;
Jibin ZHANG
;
Lei TIAN
;
Baixuan XU
;
Yan FANG
;
Yabin WANG
;
Xin LOU
;
Jinming ZHANG
;
Feng LAN
;
Feng CAO
Author Information
1. Department of Cardiology, National Research Centre for Geriatric Diseases & Second Medical Centre of Chinese People’s Liberation Army General Hospital, Chinese People’s Liberation Army Medical School, Beijing 100853, China
- Publication Type:Journal Article
- Keywords:
Myocardial infarction;
Intramyocardial transplantation;
Stem cell therapy;
Echocardiography-guided
- From:
Cardiology Discovery
2024;04(4):260-273
- CountryChina
- Language:English
-
Abstract:
Objective::To explore the approach of minimally invasive transthoracic intramyocardial cellular transplantation under echocardiographic guidance to promote ischemic myocardial repair in a preclinical big-animal study.Methods::Female Guangxi Bama miniature pigs (weight: 25–30 kg) were randomly allocated into the sham group, untreated myocardial infarction (MI) group (MI group), the MI and surgical intramyocardial injection (SIM) group (MI-SIM group), and the MI and transthoracic echocardiography-guided percutaneous intramyocardial injection (TTEPIM) group (MI-TTEPIM group) ( n = 4 each) using a lottery method. A swine MI model was established in the 3 groups excluding the sham group, and human induced pluripotent stem cell-derived cardiomyocytes (hiPS-CM) labeled with the herpes simplex virus type-1 thymidine kinase reporter gene (hiPS-CM TK+) were transplanted by SIM in MI-SIM group and TTEPIM in MI-TTEPIM group. The operation time, postoperative recovery time of animals and volume of blood loss were collected for comparison between MI-SIM group and MI-TTEPIM group. 9-(4-[ 18F] fluoro-3-(hydroxymethyl) butyl) guanine positron emission tomography/computed tomography imaging was performed to track the hiPS-CM TK+in vivo. Cardiac function and morphology were evaluated by echocardiography. Results::The operation time and postoperative recovery time of MI-TTEPIM group were significantly shorter than those of MI-SIM group ((28.3 ± 3.6) min vs. (97.0 ± 6.7) min, P < 0.001; (1.3 ± 0.3) d vs. (7.5 ± 0.9) d, P < 0.001). MI-TTEPIM also showed significantly lesser volume of blood loss during cell transplantation than MI-SIM group ((4.3 ± 0.8) mL vs. (47.0 ± 4.1) mL, P < 0.001). The transplanted cells could be traced more accurately in vivo in MI-TTEPIM than in MI-SIM. The circumferential strain of intervention region in the MI-TTEPIM group (–25.07% ± 0.27%) was significantly higher than that of the MI-SIM (–20.39% ± 0.67%) and MI groups (–19.68% ± 0.67%), respectively ( P < 0.01). Conclusion::A minimally invasive TTEPIM protocol with stem cells for treating the ischemic myocardium was established in this study. Transplantation of hiPS-CM TK+ with this method could promote the recovery of the circumferential strain of the ischemic myocardium. The findings of this study lay a foundation for the clinical transformation of this auxiliary means of treatment in the future.
